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Nutritional Basics for the Acupuncturist
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Nutritional Basics for the Acupuncturist

Instructor:  Tara Kulikov, L.Ac, MTOM, MA Kinesiology


Introduction

Nutrition for health and wellness is an area of science that is still evolving.  A lot of research has been conducted on the basic nutritional requirements for sedentary individuals, as well as for certain groups of athletes. However there is less science-based information on the nutritional requirements for specific patients in a clinical setting.  It may appear through mainstream media that there is an abundance of nutritional research available for acupuncturists and their patients to reference, yet this is not the case. Moreover, the information that is available may not be science-based.  This can lead acupuncturists to give patients dietary recommendations that do not support their specific nutritional demands. 

It is important for acupuncturists to understand the basic caloric and macronutrient needs of their patients in order to provide nutritional guidance.   Acupuncturists need to be well versed in aspects of western nutrition and then incorporate eastern nutrition guidelines in order to aid their patients in creating an optimal nutrition plan. 

Insufficient calories and/or inappropriate daily intake of macronutrients based on percentage can lead to situations of slow healing and chronic fatigue.  Too many calories can also lead to slow healing and chronic fatigue and more importantly increase a patient’s risk for numerous diseases including hyperlipidemia, certain types of cancer, diabetes, and heart disease.

A basic understanding of how to calculate caloric needs based on the Harris Benedict equation and the Basal Metabolic Rate formula along with knowledge of recommended macronutrient intake per day, will help acupuncturists to provide their patients with nutritional guidelines that can help to improve their health and well being.  



For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.


Definitions
Please take some time to familiarize yourself with the definitions, terms, and equations listed below as they will be expanded upon throughout this course.

Calorie
A unit of heat equal to the amount of heat required to raise the temperature of one kilogram of water by one degree at one atmosphere pressure; used by nutritionists to characterize the energy-producing potential in food. 

Macronutrient
A nutrient, such as a carbohydrate, fat, or protein that is needed in relatively large amounts.

Carbohydrates
Mainly sugars and starches, together constituting one of the three principal types of nutrients used as energy sources (calories) by the body.  "Carbs" can also be defined chemically as neutral compounds of carbon, hydrogen and oxygen.

Simple Carbohydrates
Various forms of sugar, such as glucose and sucrose that are composed of smaller molecules.

Complex Carbohydrates
Long- string carbohydrate molecules such as starches and fibers.

Fat
Complex molecules composed of fatty acids and glycerol.

Proteins
Large organic compounds made of amino acids arranged in a linear chain and joined together by peptide bonds between the carboxyl and amino groups of adjacent amino acid residues.

“Empty calories”  
Low-nutrient, energy-dense foods, including sugar-sweetened beverages.

Nutrient-dense foods
Food that provide substantial amounts of vitamins and minerals and relatively fewer calories.

Basal Metabolic Rate (BMR)
The rate at which the body uses energy while at rest to keep vital functions going.

Harris Benedict Equation
A formula that uses the Basal Metabolic Rate (BMR) and then applies an activity factor to determine a total daily energy expenditure (calories) of an individual. 



For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.

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Calories and the Basal Metabolic Rate (BMR)

The first step a practitioner should take in order to give nutritional guidance is to determine the patient's daily caloric needs.  This is an extremely important factor as both under and over consumption of calories can greatly harm a patient's health and slow the healing process.  An appropriate nutrition plan should have enough calories to balance energy expended and provide sufficient calories for growth, development, and healing throughout the lifecycle.  Current studies have shown that most American diets consist of too many calories.  It is important to note that dietary factors are associated with five to ten leading causes of death, including coronary heart disease, certain types of cancers, stroke, non-insulin dependent diabetes mellitus and atherosclerosis.

A calorie in simple nutritional terms is the energy potential of a food.  Energy is of critical importance to acupuncturists as we work with Qi, also a form of energy.

The first step to determine how many calories a patient needs is to determine their basal metabolic rate (BMR) which is the rate at which the body uses energy while at rest to keep vital functions going.  In other words, the BMR determines how many calories someone burns doing nothing, like watching TV all day.

 

Basal Metabolic Rate Formula

 Female BMR =   655 + (4.35 x weight in pounds) + (4.7 x height in inches) - (4.7 x age in years)
 Male BMR =
 66 + (6.23 x weight in pounds) + (12.7 x height in inches) - (6.8 x age in years)


 

 

 

For example, your patient is a 35 year old female who is 140 pounds and 5 feet 5 inches tall.  You would first convert feet to inches, so 5 feet 5 inches would be 65 inches total (1 foot = 12 inches). Next, insert her stats into the formula:

  655+ (4.35 x 140) + (4.7 x 65) - (4.7 x 35) = 1405 calories

 

 

 

Your patient has a BMR of 1405 calories;  she needs to eat 1405 calories just to maintain all of her body's functionings.  An easier way to determine somone's BMR is to use an online calculator, like this one:

http://www.bmi-calculator.net/bmr-calculator/

 

 


For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.
 

 


 


Harris Benedict Equation

Once we have established the BMR, we can now calculate the individual's daily caloric needs based on energy expenditure using the Harris Benedict Formula.

The Harris Benedict Equation uses the Basal Metabolic Rate (BMR) and then applies an activity factor to determine the total daily energy expenditure in calories.  The only factor omitted by the Harris Benedict Equation is lean body mass. Leaner bodies need more calories than less leaner ones.  Therefore, this equation will be accurate in all but the very muscular  - it will under-estimate calorie needs, and the very fat - it will over-estimate calorie needs.

First, determine BMR using the BMR calculator or the BMR formula from the previous page.

Then, multiply the BMR by the appropriate activity factor (underlined), as follows:

Sedentary Adults (little to no exercise whatsoever) Daily Calories Needed = BMR x 1.2
Lightly Active Adults (light exercise/sport participation 1-3 days per week) Daily Calories Needed = BMR x 1.375
Moderately active Adults (moderate exercise/sports participation 3-5 days per week) Daily Calories Needed = BMR x 1.55
Very Active Adults (hard exercise/sport participation 6-7 days per week) Daily Calories Needed = BMR x 1.725
Extra Active (very hard exercise/sport participation and a physical job, or training 2 times per day) Daily Calories Needed =

BMR x 1.9

 

 

Example:  Take our patient from the previous page, the 35 year old female weighing 140 pounds who is 5 feet 5 inches tall.  We determined her BMR to be 1405 calories. This patient is lightly active.  She takes her dog for a short walk every day and does a gente yoga class twice a week. Therefore, we will multiply her BMR of 1405 by 1.375 which is 1931 calories.  This is the total number of calories needed in order to maintain her current weight.  

Once you know the number of calories needed to maintain a patient's current weight, you can easily calculate the number of calories a patient needs in order to gain or lose weight.

If a patient wants to gain weight, they will need to consume more calories than they burn.  One pound of body weight is roughly equivalent of 3500 calories, so eating an extra 500 calories per day will cause patients to gain one pound per week.

Let's say our female 35 year old patient wants to lose ten pounds.  She would need to eat 1931(the total number of calories needed to keep her current weight) subtracted by 500 which is 1431.  This 500 calorie deficit will cause her to lose one pound per week if her activity level remains the same.  It will take her about 10 weeks to lose ten pounds.

Now, lets' say our 35 year old female patient was to gain five pounds.  She would need to increase her daily caloric intake by 500, so 1931 + 500 = 2431.  A 500 calorie increase will cause this patient to gain one pound a week if her activity level remains lightly active.  It will take her about five weeks to gain five pounds.

If a patient wants to lose weight, a guideline that has been established by the American College of Sports Medicine (ACSM) for lowering calorie intake is to reduce calories by at least 500, but not more than 1000 calories below maintenance level.  For people with only a small amount of weight to lose, 1000 calories will be way too little.  As a guide to minimum calorie intake, the ACSM recommends that calorie levels never drop below 1200 calories per day for women or 1800 for men.  Even these calorie levels are quite low and in many cases can cause fatigue and slow healing in patients.

Please take a moment to calculate your own BMR and then using the Harris Benedict Equation, please calculate your daily caloric needs.

The Body Mass Index Chart can serve as a guideline to help acupuncturists determine their patients weight status. Please note that this chart does not take into consideration body composition such as muscle mass and fat mass.  A very muscular patient may be indicated as "overweight" according to the BMI or a very lean athletic person may be considered "underweight" by the BMI.  If this is a concern, recommend that your patient get more advanced testing such as hydrostatic weighting, dexa scans, caliber fat tests, or pod bod to determine their body composition.

A number of Body Mass Index Charts can be found online on google images like these.  I recommend you choose one for you that is easy to read, and print it out so you can have it available as a quick reference for your patients.

 

 


For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.
 

 

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Macronutrients

Once the total necessary calories have been calculated, the percentage of each macronutrient consumed per day should be determined.  Each patient is unique in regards to age, gender, height, weight, and activity level, thus every nutrition plan should reflect these factors in terms of caloric intake.  

A macronutrient is a nutrient, such as a carbohydrate, fat, or protein that is needed in relatively large amounts in the diet.  Each macronutrient serves numerous functions in the body and is required in different percentages based on activity level.

The USDA Food Guide recommends that most adults consume 18% of their calories from protein, 29% from fat, and 53% from carbohydrates.  This is a general recommendation for sedentary to slightly active individuals (www.usda.gov is a good resource for practitioners to reference current information on the USDA's findings).

The average American diet consists of 50% of calories coming from carbohydrates (mainly from simple sugars), 34% from fat, and 16% from protein.  These ratios translate into too much fat, as 34% is much higher than the USDA's recommendation.  Too many calories contribute to the obesity epidemic seen in this country.

The Institute of Medicine Food & Nutrition Board established new dietary guidelines in 2002 for macronutrient consumption call the Acceptable Macronutrient Distribution Range (AMDR).  These guidelines were designed to avoid nutrient deficiencies that seem to occur when macronutrient consumption falls above or below the recommended levels.  The AMDR recommendations have been incorporated into the 2005 Dietary Guidelines for Americans and advocate 45-65% of their total calories from carbohydrates, 20-35% from fat, and 10-35% from protein.  These ranges are very similar to the USDA's Food Guide recommendations, but they also incorporate wider ranges that can be modified for different population groups like pregnant women, children, and adolescents.

Another population group that requires a modification in their macronutrient ratios is athletes. Research has shown that very athletic/endurance athletes (such as a marathon runner) can benefit from consuming 60-70% of their calories from carbohdydrates, 15% from protein, and 10-15% from fat.  Very athletic/strength and power athletes (such as sprinters or football players) can benefit from consuming 55-65% of their calories from carbohydrates, 15-18% from protein, and 20-25% from fat.  These ranges vary according to varying activity level during training and or competition.

Exact macronutrient needs will vary according to activity level.  For example, people partaking in very strenuous activity may need a higher percentage of carbohydrates.

 

 


For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.

 


 

 

 



Macronutrients in various patient populations

There is no hard scientific evidence to exactly calculate the macronutrient needs of pregnant or lactating women.  However, it has been established that these groups of women do require more macronutrients, so this chart can serve as a basic guideline and then be adapted on individual cases.

Pregnant Women 170 grams of carbs per day 1.10 grams of protein per day 20-35% of fat per day 28 grams of fiber per day
Lactating Women 210 grams of carbs per day 1.10 grams of protein per day 20-35% of fat per day 29 grams of fiber per day

 

 

 

 

Children, adolescents, adults, and people suffering from certain diseases may also have different macronutrient requirements.  The charts below gives some recommendations for various population groups and these ranges should be considered when designing a nutrition plan for these populations.  For more information regarding specific groups, please refer to the USDA's website for macronutrient intake requirements for different lifecycle stages.

Group Carbohydrate (grams/day) Protein (grams/kg/day) Fat (% of total energy) Fiber (grams/day)
Girls 4-8 130 .95 20-35 25
Girls 9-13 130 .95 20-35 26
Girls 14-18 130 .85 20-35 26
Boys 4-8 130 .95 20-35 25
Boys 9-13 130 .95 20-35 31
Boys 14-18 130 .95 20-35 38
Men 19-49 130 .80 20-35 38
Men 50 & up 130 .80 20-35 30
Women 19-49 130 .80 20-35 25
Women 50 & up 130 .80 20-35 28


Calculating the Ratios of Food

If your patient wants to gain or lose weight, they will need to accurately determine how many calories from carbohydrates, fat, and protein they are eating.  

The following is a simple calculation to do so.  First, calculate the total calories in the meal:

 (grams of protein x 4)  +  (grams of fat x 9)  +  (grams of carbs x 4)  =
 total calories

 

 

Then, for protein:

 (grams of protein x 4)  ÷ 
 total calories  = 
 percentage of calories from protein

 

 

For fat:

 (grams of fat x 9)  ÷  total calories  =  percentage of calories from fat

 

 

For carbs:

 (grams of carbs x 4)  ÷
 total calories  =  percentage of calories from carbs

 

 

If your food label only has percentages of these macronutrients, here is a simple calculation to convert percentages to grams:

For protein:

 daily calories  x  percent protein  ÷  4 calories per gram  =  grams protein

 

For fat:

 daily calories  x  percent fat  ÷  9 calories per gram  =  grams fat

And for carbs:

 daily calories  x   percent carbs  ÷  4 calories per gram  =  grams carbs

 

 

Online sources such as www.calorieking.com or myfooddiary.com are free sources that can be accessed to calculate calories in food.  Professional software such as NutritionCalc Plus or NutriNote are more comprehensive programs that can be used to calculate nutritional information.

 

 


For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.


Carbohydrates

Carbohydrates are sugars that provide the body with energy that is required to carry out daily activities of exercise. Three kinds of carbohydrates exist:  oligosaccharides (disaccharides like sucrose, lactose, and maltose); polysaccharides that contain three or more simple sugars to form starch, cellulose, and glycogen; and monosaccharide (simple sugars like glucose and fructose). The two main types of carbohydrates in food are categorized as simple carbohydrates (sugars) and complex carbohydrates (starches and dietary fiber).  

As carbohydrates are taken into the body, they are broken down and used as energy.  When the body does not need to use the carbohydrates for energy, they are stored in the liver and muscles in the form of glycogen.  When the liver and muscle cells cannot store anymore glycogen, it is turned into fat.

The body needs a constant supply of energy to function properly and a lack of carbohydrates in the diet can cause tiredness or fatigue, poor mental function, lack of endurance and stamina, and slow healing.  Carbohydrates are also crucial for proper brain function, heart and nervous system function, and for the digestive and immune systems.  Lastly, fiber, which is a form of carbohydrate, is essential for elimination of waste materials and toxins from the body and helps to keep the intestines disease-free and clean.

People who train for athletic events are constantly depleted of vital macronutrients that are required for energy production.  Of the three main macronutrients, carbohydrate may be the most dependent variable when it comes to energy use during exercise and may therefore significantly influence athletic performance.  During high-intensity exercise, carbohydrate is the main fuel source for muscle contraction via muscle and liver glycogen.  Fat and protein metabolism is also dependent upon the presence of carbohydrate and the nervous system relies exclusively on carbohydrates for energy.  This is why people who exercise a lot need to consume more carbohydrates than non-exercisers.

It is typically recommended that people consume carbohydrates in the complex form (such as whole grains, fruits, vegetables and legumes) in order to obtain sources of fiber, iron (if enriched), and B vitamins necessary for energy metabolism.

As mentioned previously, the USDA recommends that average adults consume 53% of their calories in the form of carbohydrates.  It is also recommended that very athletic endurance athletes consume 65-70% of their calories in the form of carbohydrates and very athletic strength and power athletes get 55-65% of their calories from carbohydrates.

The following is a list of whole grains, the "good" carbs, and refined grains, the carbs that are less desirable.

Whole Grains Refined Grains
Whole wheat bread White Bread
Whole grain cereals High sugar cereals
Brown rice White rice
Whole wheat pasta White pasta
Barley Croissants
Bulgur wheat Crackers
Oatmeal Bagels

Quinoa

 
Spelt berries  
Wheat pita bread  
Whole grain tortillas  
Whole wheat couscous  











 

 

Source: Fink, H., Burgoon, L., Mikesky, A. (2006).  Practical Applications in Sports Nutrition.  Jones & Bartlett Publishing.

 

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For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.
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Glycemic Index

Acupuncturists should familiarize themselves with glycemic index to ensure that their patients are eating carbohydrates from appropriate sources.  The glycemic-index (GI) is based upon a method of classifying food according to how quickly the fuel is digested, broken down into glucose, and absorbed into the bloodstream. Low GI foods are slowly digested and glucose appears in the bloodstream at a slower rate whereas high GI foods have the opposite effect.  They are quickly digested and glucose appears in the bloodstream more rapidly.

Some research has suggested that it may be beneficial to consume high GI foods immediately post-exercise in order to quickly induce glycogen synthesis.  Overall, the majority of carbohydrates consumed throughout the day should be on the lower end of the GI.  Research has indicated that lower GI foods can help to prevent surges in blood glucose and insulin whereby stabilizing energy levels and decreasing hunger.

Take a moment to look at this Glycemic Index chart.  You might be surprised to learn that foods you or your patients may be eating on a regular basis have a higher glycemic index than one would expect. 

     Food Glycemic Index Glycemic Index Category* Serving Size (g)

gCHO/serving

(grams of carbs per serving)

White bread, Wonder 105 High 30 14
White rice, boiled 91 High 150 36
Couscous 93 High 150 35
Gatorade 111 High 250mL 15
Ice Cream 87 High 50 13
Sweet potato 89 High 150 28
Baked potato, russet 121 High 150 30
Cranberry juice cocktail 97 High 250 mL 36
Grapenuts cereal 102 High 30 21
Cornflakes 116 High 30 26
Blueberry muffin 84 High 57 29
Power bar 79 Med 65 42
Honey 78 Med 25 18
White rice, long grain 80 Med 150 41
Coca cola 83 Med 250 mL 26
Sweet corn 78 Med 80 17
Carrot 68 Med 80 6
New potato 81 Med 150 21
Banana 74 Med 120 24
Orange juice 71 Med 250mL 26
Chickpeas 39 Low 150 30
Kidney Beans 39 Low 150 25
Xylitol 11 Low 10 10
Lentils 41 Low 150 18
Chocolate cake, frosted 54 Low 111 52
Fructose 27 Low 10 10
Tomato juice 54 Low 250mL 9
Skim milk 46 Low 250mL 13
Apple 52 Low 120 15

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Category = High (>85); Medium (60-50); Low (<60)

 

Note:  Food items such as chocolate cake with frosting show up as "low" on the GI because of the high fat content of frosting.  Fat slows down the rate of sugar absorption.

Are you taking this course for NCCAOM PDA's?  If so, please fill out the second worksheet question.


 


 


For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.
 

 


Proteins

Protein serves numerous functions in the body.  Some of these functions include:  growth, repair, and maintenance of body tissues;  production of many hormones, enzymes, and hemoglobin;  structural component of the cell;  serves as a buffer in the control of acid-base balance; helps maintain normal blood osmotic pressure;  helps to form antibodies for disease protection, and produces energy.

As previously mentioned, the USDA recommends that most adults get 18% of their total calories from protein.  Considering we need protein to help our bodies carry out and sustain essential physiological functions, a diet that is insufficient in protein, could lead to deficiency of important vitamins and minerals found in protein-rich foods.  Niacin, thiamin, riboflavin, B-12, B-6, iron, zinc, and calcium are some examples of vitamins and minerals that could be deficient due to a low protein diet.  The effects are prolonged low protein in the diet would eventually manifest itself as impaired muscle growth and development, impaired immune function, and irregularities in other bodily functions and systems described above.

On the opposite spectrum, there is some evidence that very high protein diets (over 2g/kg of body weight per day) may contribute to progressive renal failure.  Two other safety concerns that have been publicized by popular media and in certain textbooks are calcium loss and or bone catabolism and the association of lower fiber and higher saturated fat diets with higher protein intakes.  The validity surrounding these three claims lacks strong scientific evidence yet it is still suggested that most adults consume a balanced protein intake not to exceed 2 grams per kilogram of body weight per day.

A variety of lean meats, eggs, milk, yogurt, and cottage cheese are recommended sources of protein due to their amino acid profile and overall nutrient content.  Soy products which also contain an ideal amino acid profile and high protein content can be eaten as well.  Other food sources such as beans, nuts, seeds, lentils and grains supply protein in smaller amounts, and they lack certain amino acids classifying them as "incomplete" proteins.  By combining a variety of these "incomplete" sources, such as beans with rice, peanut butter with whole wheat bread, or hummus with whole wheat crackers, these "incomplete" sources become "complete" proteins.

 

Food

Serving Size

Protein Grams

Brown rice

1 cup cooked

5

Whole wheat bread

2 slices

6

Oatmeal

1 cup cooked

6

Spaghetti noodles

1 cup cooked

7

Pork and beans

1/2 cup

7

Cheese

1 oz.

7

Milk

1 cup

8

Food

Serving Size

Protein Grams

Peanut butter

2 Tbsp.

8

Tofu

              1/2 cup

10

Cottage cheese

1/2 cup

14

Plain yogurt

1 cup

14

Scrambled eggs

3

19

Canned salmon

1/2 cup

24

Scrambled eggs

3

19

Canned salmon

1/2 cup

24

Roast beef or lean meat

3 oz.

24

Pork loin

3 oz.

25

Canned tuna

1/2 cup

26

Chicken breast

3 oz.

26

Turkey breast

3 oz.

26



Are you taking this course for NCCAOM PDA's?  If so, please follow the link to your third worksheet question.

 



For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.
 

 


Fat

Fat has many vital functions in the body which include:

• Energy - fat provides up to 70% of total energy at a resting state

• Nerves - fat is a component of nerve fibers and cell membranes

• Protection - fat cushions and supports vital organs

• Hormones - fat helps to produce certain hormones in the body

• Storage and transportation - fat stores and transports fat-soluble vitamins

• Insulation - fat preserves body heat

The USDA recommends that adults consume no more than 29% of their total daily calories from sources of fat (this percentage varies for other population groups so reference the previously listed recommendations). Diets that are very low in fat (less than 20% of total calories consumed per day) can decrease the vital functions that fat serves in the body. Diets that are very high in fat (over 30% of total calories consumed per day) are associated with a number of diseases including hyperlipidemia, atherosclerosis, certain types of cancer, type 2 diabetes, as well as obesity and the associated risks of obesity.
 
Sources of Fat
The proportion of fat intake should be derived from the following:
Saturated/Trans Fats: <10%
Polyunsaturated: ~10%
Monounsaturated: ~10%
 
Healthier Fats (Unsaturated fats)
When choosing fat sources, it is recommended that individuals primarily consume unsaturated fats, such as monounsaturated and polyunsaturated fats (see chart below).  These fats can aid in lowering the risk of certain chronic diseases, such as heart disease.  Total cholesterol and low-density lipoprotein (LDL) cholesterol ("bad" cholesterol), can be reduced by consuming unsaturated fat.
 
It has been found that polyunsaturated and omega-3 fatty acids in particular may be especially beneficial to your heart. Omega-3 fatty acid consumption has been associated with a decrease in the risk of coronary artery disease, protection against irregular heartbeats, and may help lower blood pressure levels (8, 24).
 
Food Sources of Healthier Fats

Healthier Fats

Food Source

Monounsaturated fat

Olive oil, peanut oil, canola oil, avocados, nuts and seeds 

Polyunsaturated fat

Vegetable oils (such as safflower, corn, sunflower, soy and cottonseed oils), nuts and seeds 

Omega-3 fatty acids

Fatty, cold-water fish (such as salmon, mackerel and herring), flaxseeds, flax oil and walnuts 

Adapted from:  Mayo Foundation for Medical Education and Research (MFMER).  www.mayoclinic.com.  2010.

 

Less Healthy Fats (Saturated Fats)

Less than ten percent of consumed fats should come from saturated fat, as this is the least healthy type of fat. Excessive consumption of saturated fat has been associated with and increase of certain chronic diseases - namely heart disease.  Elevated levels of LDL ("bad" cholesterol) have been shown to increase from diets high in saturated fat. Excessive intake of "trans fat" has also been associated with an increase in blood cholesterol levels and should, therefore, be consumed at less than ten percent of total fat intake.

Food Sources of Less Healthy Fats

Less Healthy Fats

Food Source

Saturated fat

Animal products (such as meat, poultry, seafood, eggs, dairy products, lard and butter), and coconut, palm and other tropical oils

Trans fat

Partially hydrogenated vegetable oils, commercial baked goods (such as crackers, cookies and cakes), fried foods (such as doughnuts and french fries), shortening and margarine

Adapted from:  Mayo Foundation for Medical Education and Research (MFMER).  www.mayoclinic.com.  2010.

 

For a detailed list of the fat content of various foods, please see Appendix 1 at the end of the course.


Are you taking this course for NCCAOM PDA's?  If so, please follow this link to your final worksheet question.


 

 


For the acupuncture and Chinese medicine community:  If you would like California or NCCAOM continuing education credit for this course, click on the green button on the top right hand corner of the screen that says "Go to Quiz" after completing the course.

 
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Nutrient-Dense Food

Lastly, a new focus in nutrition has been on advocating the consumption of nutrient-dense foods. Nutrient-dense food can be defined as food that provides substantial amounts of vitamins and minerals and relatively fewer calories.  Examples of nutrient-dense food includes whole-grain breads, rice, beans, vegetables and fruit.

On the opposite spectrum, "empty calories" are foods that are low-nurient, energy-dense foods, including sugar-sweetened beverages.  Examples of these types of food are candy bars, donuts, cookies and chips.

The theory is that if people consume more nutrient-dense foods, they will be able to meet their nutritional needs without consuming too many calories.  This may be a way to help fight the obesity epidemic in the United States and to assure that patients are getting the optimal benefits from the food they eat.

Conclusion

Our patients look to us for far more than acupuncture and Chinese herbal medicine when they are sick.  They look to us to guide them on how to be healthy, and nutrition is paramount in the quest for living disease-free.  With the tools learned in this course, you can now calculate the daily caloric needs of your patients and guide them to make healthier food choices.

You are now ready to take the Quiz for this course to get CEU credit.  Simply press the "Go To Quiz" icon at the top right hand corner of the page. 

References

1.  Aldoori, W., Ryan-Harshman, M.. Food for Thought: New dietary reference intakes for macronutrients and fibre. Clinical Practice, 2009. Clinical Practice. 4 (3): p. 12-23. 

2.  American Dietetics Association, Dietetic Association of Canada, American College of Sports Medicine. Joint Position Statement: Nutrition and Athletic Performance. Medicine and Science in Sport and Exercise, 2009: p. 2130-2145.

3.  Beers, M.H., Berkow, R. (1999). The merk manual of diagnosis and Therapy (17th ed.). New York: Random House. 

4.  Bidlack, R.  Interrelationship of food, nutrition, diet, and health: the national association of state universities and land grant colleges white paper.  J Am Coll Nutr, 2006. 15(5): p.422-33.  

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Appendix 1

Fat Content of Various Foods

Food Item Serving Size Total Fat Saturated Monounsaturated Polyunsaturated
Grains
Oatmeal, dry 1/2 c. 2.5 0.5 1.0 1.0
English muffin 1 muffin 1 0.2 .02 0.5
Pasta, cooked 1 cup 0.9 0.1 0.1 0.4
Brown Rice 1 cup 1.8 0.4 0.6 0.6
Whole wheat pita 1 pita 1.7 0.3 0.2 0.7
Blueberry muffin 1 muffin 6.2 1.2 1.5 3.1
Biscuit 1.2 oz 4.6 0.9 2.8 0.2
Fruits/Vegetables
Pear 1 medium 0.5 <0.1 0.1 0.2
Orange 1 medium 0 0 0 0
Watermelon 1 cup 0.7 0.1 0.2 0.2
Banana 1 medium 0.5 0.2 <0.1 0.1
Spinach, raw 1/2 cup 0 0 0 0
Broccoli, cooked 1/2 cup 0.1 <0.1 <0.1 <0.1 0
Carrots, cooked 1/2 cup 0.1 <0.1 <0.1 0
Avocado 1 medium 27 5.3 14.8 4.5
Milk/Milk Alternatives
Skim milk 8 oz. 0.5 0.4 0.2 <0.1
1% milk 8 oz. 2.6 1.6 0.7 0.1
2% milk 8 oz. 4.7 2.9 1.4 0.2
Whole milk 8 oz. 8 5.1 2.4 0.3
Cottage cheese, 2% 1/4 c 4.4 2.8 1.2 0.1
Swiss Cheese 1 oz 8 5.0 2.1 0.3
Soy milk 8 oz 5 0.5 1.0 3.0
Meat and Beans/Alternative
Ground beef, lean 3 oz 13.2 5.2 5.8 0.4
Chicken with skin 3 oz 9 2.4 3.4 1.0
Chicken without skin 3 oz 3.1 0.9 1.1 0.7
Turkey, white meat (without skin) 3 oz 3 1.0 0.6 0.9
Turkey, dark (without skin0 3 oz 6 2.2 1.5 2.0
Pork chop 3 oz 6.9 2.5 3.1 2.0
Salmon, pink 3 oz 4 1.0 0.8 0.6
Orange roughy 3 oz 1 0.1 0.5 <0.1
Veggie burger 1 patty 0.5 0.1 0.3 0.2
Almonds 1 oz. 15 1.1 9.5 3.6
Oils
Margarine, stick 1 T 11 2.1 5.2 3.2
Butter 1 T 12 7.2 3.3 0.4
Olive Oil 1 T 14 1.8 9.9 1.1
Salad dressing, ranch 2 T 18 2.5 NA NA
Salad dressing, reduced calorie ranch 2 T 5 0.4 NA NA

Source:   Fink, H., Burgoon, L., Mikesky, A. (2006).  Practical Applications in Sports Nutrition.  Jones & Bartlett Publishing


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